By Sue Hubbard, M.D.
This time of year, kids spend a lot of time in the water, which can lead to a painful condition called “swimmer’s ear” (otitis externa). This is a common summer infection of the external auditory canal, the portion of the ear that connects the outer ear (where the Q-tip goes, but really shouldn’t!) to the inner ear.
Swimmer’s ear often develops in school- age children who spend much of the summer splashing in pools, lakes, or even the ocean. The ear canal just never gets a chance to dry out, and the constant moisture disrupts the skin’s natural barrier to infection.
The skin may then develop micro-abrasions, which allow bacteria to penetrate, and a painful infection develops. The most common bacterial infection is due to the bacteria Pseudomonas aeruginosa.
A child with swimmer’s ear will usually complain when you touch one of his/her ears, or tug on an ear lobe. They often complain when they’re lying down and roll over on the affected ear. Swimmer’s ear can be extremely painful and awaken your child from sleep.
In severe cases, the ear canal may be so swollen that it appears smaller than usual, and is red and tender. Sometimes, you may see discharge from the ear canal due to the infection and subsequent inflammatory response.
The best treatment for swimmer’s ear is an antibiotic drop instilled into the ear canal. I often use an antibiotic drop in combination with a steroid to provide anti-inflammatory effects which will help reduce local swelling and irritation.
In severe cases, it may be difficult to get the dropper into the ear due to the swelling, so your doctor may place a “wick” into the child’s ear to open the ear canal and allow the drops to enter. A child may also need pain control with either acetaminophen or ibuprofen.
During the time you’re using the topical drops, your child needs to keep water out of the affected ear. This is the hardest part of the treatment, as young children are such water bugs. This also means not getting the ear wet when bathing or showering. I usually tell patients to wait 4-5 days before returning to the water.
To help prevent swimmer’s ear, you can either buy a premixed solution called Swim Ear at the pharmacy, or mix up your own thrifty bottle using 1/2 white vinegar and 1/2 alcohol. Keep the bottle handy by the back door if you have a pool, or in your child’s beach bag. After each swim, apply a few drops to each ear and wiggle the ear around. This will help dry out the ear.
Once your child is a “fish” and their heads are under water a good deal of the time, this a good time to start using this product. It’s unusual to see a baby or toddler with swimmer’s ear, however, but prevention is the key. A painful ear is not fun, and staying out of the pool just adds insult to injury!
Dr. Sue Hubbard is an award-winning pediatrician, medical editor and media host. “The Kid’s Doctor” TV feature can be seen on more than 90 stations across the U.S. Submit questions at http://www.kidsdr.com. The Kid’s Doctor e-book, “Tattoos to Texting: Parenting Today’s Teen,” is now available from Amazon and other e-book vendors.
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This column was printed in the July 26, 2015 - August 8, 2015 edition.